Management of shotgun-induced fractures of the humerus with Ilizarov external fixator

Abstract We retrospectively reviewed 11 shotgun-induced open humeral fractures treated with immediate application of Ilizarov type ring external fixation. Eight patients had grade III A and three had grade III B open fractures. No patient had associated neurovascular injury. All fractures were stabilized with Ilizarov external fixator immediately after meticulous debridement and irrigation under emergent conditions. Complete bony union occurred in all patients in 14–44 weeks (mean, 21 weeks). One patient required a second intervention to adjust the external fixator rings. Two patients required a rotational fasciocutaneous flap to handle the soft tissue coverage problem. Superficial pin tract infection was present in eight patients; however none of them had deep infection or osteomyelitis. A good to excellent result was achieved in 10 patients according to the rating system of Smith and Cooney. Immediate Ilizarov external fixation is a safe method of obtaining a functional limb in the treatment of shotgun-induced open humeral fractures with severe soft tissue damage.